Povidone-iodine solution is an effective "antiseptic" agent on normal skin. However, it is not a very effective antiseptic agent in full-thickness wounds.1 The usual explanation given for povidone-iodine solution's ineffectiveness in full-thickness wounds is that wounds, unlike normal skin, contain wound fluids. The wound's fluid proteins bind iodine, the active agent in povidone-iodine solution, and thereby reduce the solution's effectiveness.2 An alternative explanation for the lack of effect in full-thickness wounds might be that the wound fluids provide the bacteria a "protective coating."3 The latter possibility has been proposed to explain the ability of Pseudomonas cepacia to survive in povidone-iodine solution.Regardless of the mechanisms of the inactivity of povidone-iodine in deep wounds, our findings in superficial wounds are not surprising. As Dr Leyden points out, we used only one application of a small volume of povidone-iodine into a shallow wound containing large numbers of
Mertz PM, Eaglstein WH. Topical Antiseptics-Reply. Arch Dermatol. 1984;120(11):1419. doi:10.1001/archderm.1984.01650470025007
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